PeoplesMeds Mail Order Form:
| Return to the Order Page |
Contact and billing information:
| Name: | |
| Street Address: | |
| Address 2 (if needed) | |
| City, State and Zip: | |
| Country | |
| E-mail: |
| Phone: [ ] Day or [ ] Evening | ( ) |
Special instructions:
Order information (click here to see an example)
| Product Name and Description | PRICE | QUANTITY |
TOTAL |
| Prescription Guide To Mexico, Europe and Canada | $14.95 | ||
|
(Standard Shipping and handling for all 50 U.S. states and Foreign Countries) |
5.00 |
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Subtotal |
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Additional Shipping Fee For
Express USPS shipping U.S. 50 states and territories
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(Additional Shipping and handling Charge for CANADA delivery ONLY)
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(Additional Air Mail
Shipping and handling for all other countries) |
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(Additional Priority Air Mail Shipping and handling Charge for all other countries)
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Subtotal
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TOTAL |
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Please make your check or money order payable to
United Publishing,
Please send check or money order (U.S. funds only) to:
Instructions: Please print the above form
on your printer. With your mouse
HIGHLIGHT everything above these instructions. Click the FILE
option
in the upper left corner of this screen. Go down the options to PRINT
option and click it. When the new window opens, click the SELECTION
button. Then click the OK Button. When the above form
prints out,
fill out form as necessary, refer to the example below if necessary, then
send it along with payment to the above address.
| Return to the Order Page |
SAMPLE
Contact and billing information:
| Name: |
John Doe
|
| Street Address: |
5555 Oak Street
|
| Address 2 (if needed) |
Suite 3B
|
| City, State and Zip: |
Mountain Town, NY
10433
|
| Country |
USA
|
| E-mail: |
john@dot.com |
| Phone: [ X ] Day or [ ] Evening |
( 222 ) 222-2222 |
Special instructions:
| Do not ship Until Monday. I
will be back from my business trip then. Thank you.
|
Order information
| Product Name and Description | PRICE | QUANTITY |
TOTAL |
| Prescription Guide To Mexico, Europe and Canada | $14.95 | ||
| Prescription Guide To Europe and Canada | $14.95 |
1 |
14.95 |
| Prescription Guide To Mexico, Europe and Canada | $24.95 | ||
|
(Standard Shipping and handling for all U.S. 50 states and Foreign Countries) |
5.00 |
||
|
Subtotal |
19.95 |
||
|
Additional Shipping Fee For Express USPS shipping 50 U.S. states and territories (Available only with Money Order Payment) Add $20.00 |
|||
|
(Additional Shipping and handling Charge for CANADA delivery ONLY)
|
|||
|
(Additional Air Mail
Shipping and handling for all other countries) |
|||
|
(Additional Priority Air Mail Shipping and handling Charge for all other countries)
|
|||
|
Subtotal
|
19.95 |
||
|
TOTAL |
19.95 |
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